CURRENT EARLY RESULTS OF PULMONARY THROMBOENDARTERECTOMY FOR CHRONIC PULMONARY-EMBOLISM

被引：30

作者：

DAILY, PO ^{[1
]}

DEMBITZSKY, WP ^{[1
]}

IVERSEN, S ^{[1
]}

MOSER, KM ^{[1
]}

AUGER, W ^{[1
]}

机构：

[1] SHARP MEM HOSP & REHABIL CTR,SAN DIEGO,CA

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1990年 / 4卷 / 03期

关键词：

Chronic pulmonary embolism; Elevated pulmonary vascular resistance; Pulmonary hypertension; Pulmonary thromboendarterectomy;

D O I：

10.1016/1010-7940(90)90181-X

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Some patients with chronic pulmonary embolism causing severely symptomatic pulmonary hypertension have been managed by heart-lungtransplantation with an associated hospital mortality of 24%. To allow comparison with pulmonary thromboendarterectomy (PTE), we have reviewed the hospital morbidity and mortality in 149 consecutive patients. From 1 October 1984 to 18 September 1989, these patients underwent PTE utilizing astandardized procedure consisting of median sternotomy, cardiopulmonary bypass, deep hypothermia and circulatory arrest for bilateral PTE in 91%(136/149) of the procedures with 7.4% (11/149) and 1.3% (2/149) undergoingright or left PTE, respectively. Ventilator dependency (≥ to 5 days on respirator) occurred in 28.3% (41/146). Hospital mortality (death within 30 days or in hospital) was 11.4% (17/149). Themost common causes of death were respiratory and multiorgan failure, 10(59% of deaths) and acute pulmonary hemorrhage, 3 (17% of deaths). We conclude that PTE with an operative mortality of half that of heart-lung transplantation (11.4% vs. 24%) should be the procedure of choice forsignificantly symptomatic chronic pulmonary embolism. Furthermore, the hazards of immuno suppression and chronic graft rejection are avoided. [Eur J Cardiothorac Surg (1990) 4: 117 - 1231. © Springer-Verlag.

引用

页码：117 / 123

页数：7

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